When your Child Needs Emergency Medical Services

It is rare for children to become seriously ill without warning. Based on your child's symptoms, you should usually contact your family physician for advice. Remember timely treatment of symptoms can prevent an illness from getting worse or turning into an emergency.

Important Emergency Phone Numbers

  Keep the following numbers handy by taping them on or near your phone:

• Your home phone and address
• Your family doctor's
• Your child's pediatrician's
• Nearest hospital
• Ambulance
• Police
• Fire department
• Dentist

It is important that your maid/ baby sitters know where to find emergency phone numbers. Be sure your sitter knows your home address and phone number. Always leave your sitter the phone number and address where you can be located. In today's time of mobile phones this is easier. If your phone has a commonly used phones directory, enter at least doctors phone no on it or make use of MTNL's abbreviated dialing service Remember, for any emergency always call your doctor. If your child is seriously ill or injured, it may be safer for your child to be transported by emergency medical services.

What is a true emergency?

A true emergency is when you believe a severe injury or illness is threatening your child's life or may cause permanent damage. In such a case, your child needs emergency treatment right away. Ideally, you should discuss with your family doctor in advance what you should do in case of a true emergency. Many true emergencies involve sudden injuries often caused by one of the following:

• Bicycle or car crashes, falls or other violent impacts
• Poisoning
• Burns or smoke inhalation
• Choking
• Near drowning
• Electric shocks

Other true emergencies can result from either medical illnesses or injuries. You can often tell that a emergency is about to occur, if you observe your child showing any of the following:

• Acting strangely or becoming more withdrawn, less alert
• Increasing trouble with breathing
• Bleeding that does not stop
• Skin or lips that look blue or purple (or gray for darker-skinned children)
• Rhythmical jerking and loss of consciousness (a fit)
• Unconsciousness
• Very loose or knocked-out teeth, or other major mouth or facial injuries
• Increasing or severe persistent pain
• A cut or burn that is large or deep
• Any loss of consciousness, confusion, a bad headache or vomiting several times
• Decreasing responsiveness when you talk to your child

Call your doctor at once if your child has swallowed another person's medication or suspected poison even if he has no signs or symptoms. Always call for help if you are concerned that your child's life may be in danger or that your child is seriously hurt. DO NOT wait for the doctor to reach the clinic.

In case of a true emergency

• Stay calm.
• If needed and you can, start rescue breathing or CPR (cardiopulmonary resuscitation).
• If you need immediate help call your family physician and state clearly that you have an emergency.
• If there is bleeding, apply continuous pressure to the site with a clean cloth. Do not waste time in getting gauze from your neighbor.
• If your child is having a seizure, place him/ her on floor with head turned to the side, and stay with your child until help arrives.
• If you have to go to a hospital, carry any medication your child is taking and his immunization record. Also carry any other medications or suspected poisons your child might have taken.

Example - A child may be given 'X' drug for fever and tolerates it. After about a year during which the drug has been administered at least 10 times, when the same drug is given child may get allergic reaction which could be life threatening.

Signs of a dangerous allergic reaction

1. Difficult breathing
2. Cough
3. Headache
4. Unconsciousness

Immediate medical attention is needed if an allergic reaction develops. Always identify what the child was exposed to - either food, drug, environment or contact allergen like soap etc. If a medicine given by your doctor causes Allergy, ask your doctor to write it down to keep as record and to show to any other doctor you may have to go to.

Common emergencies - what to do?

1. Get the child away from the snake.
2. If possible remember what the snake looks like. It will help your doctor to begin treatment.
3. Check the snakebite for puncture wounds. If one or two fang marks can be seen, the bite could be from a poisonous pit viper.
4. Keep the child calm, lying down and with the bitten arm or leg hanging below the level of his heart to slow the blood flowing from the wound to the heart. The more the victim moves the faster the venom spreads through the body.
5. Clean the wound. Be sure to wipe away from the bite. This keeps any venom on the unbroken skin around the bite from being wiped into the wound.
6. Get the victim to the hospital as soon as possible.
7. Watch for general symptom (ie severe pain, swelling around the bite, bluish discoloration around the bite, extreme weakness, shortness of breath, blurred vision, drowsiness, or vomiting.

If any of the above mentioned symptoms occur within 30 minutes from the time of the bite, and you may still take some time till your child gets medical help, tie a constricting band (³/₄ to 1 ¹/₂ inches wide; NOT a rope or string) two inches above the bite or above the swelling. The band needs to be loose enough to slip a finger underneath it. The band slows blood flow away from the bite, keeping the venom from reaching the heart. The band must be applied within 30 minutes after the time of the bite to be effective. If the swelling spreads, move the band so that it is always two inches above the swelling.

1. Nose injury.
2. Strenuous activity.
3. Exposure to high altitudes.
4. Blowing nose too hard.

Steps to be taken in case of a nose bleed

1. Make the child sit down and lean slightly forward to prevent blood from draining into the throat.
2. Place a cold, wet cloth on the nose to constrict the blood vessels and stop the bleeding.
3. If blood is coming from only one nostril, press firmly at the top of that nostril.
4. If both nostrils are bleeding, pinch them together for at least 10 minutes.
5. If bleeding continues, apply pressure for another 10 minutes.
6. If the bleeding is the result of direct injury to the nose, only gentle pressure should be applied.
7. If heavy bleeding persists or if nosebleeds recur frequently, consult a physician or take your child to a hospital.
8. In case your child gets nose bleed often, ask your doctor to teach you how to pack his nostril with gauze.

1. Cool the body of a heatstroke victim immediately.
2. If possible put him in a cool water tub; wrap him in cool wet clothes; or sponge his skin with cool water, rubbing alcohol, ice, or cold packs.
3. Once the child's temperature drops to about 101 F, you may make him lie down in a cool room.
4. If the temperature begins to rise again, you will need to repeat the cooling process.
5. If he/she is able to drink, you may give him some water.

• Vomiting after injury
• Bleeding from ear, nose or throat
• History of unconsciousness or confusion

has to be observed for at least 24 hours for a suspected injury to the brain. Inform your doctor immediately and seek guidance. An injury may appear too trivial, DO NOT think it is unnecessary panic. Follow your doctors instructions.

Symptoms to look for if you suspect a child may have a brain injury

1. Clear or reddish fluid draining from the ears, nose, or mouth
2. Difficulty in speaking
3. Headache
4. Pale skin

Proper Care

1. While waiting for help to arrive, keep the child lying down in the recovery position
2. Control any bleeding, and be sure that he is breathing properly.
3. Do not give the child anything to eat or drink.
4. If the child becomes unconscious for any amount of time, keep track of this information so that you can report it.

Symptoms

1. Child's muscles become stiff and hard, followed by jerking movements
2. He may bite his tongue or stop breathing
3. Face and lips may turn a bluish color
4. May foam at the mouth or drool excessively

What to do

1. Clear all objects away from the child and place something soft under his head
2. Do not place anything (like a spoon) between his teeth or in his mouth
3. Do not give him any liquids
4. If the childstops breathing, check to see that the airway is open; very often lot of secretions/ phlegm is blocking the throat.
5. Stay calm and keep the child comfortable until help arrives.
6. Most convulsions are followed by a period of unconsciousness or another convulsion.

1. Accidental fire
2. Kerosene oil, stoves and flammable fabrics
3. Chemical burns by caustic soda and acids
4. Electrical burns by heaters and unprotected electric points

Assessment of burns:

Depending upon the age, the percentage and body surface burnt can be calculated.

Important Pointers in Treatment

1. Never put butter or greasy ointments on a burn. They seal heat into the wound and may cause infection. Do not put toothpaste, ink or similar things on burns
2. Always seek medical attention, more so if...
   • Victim is a small child
   • Burn covers more than one body part
   • Burn is located on any sensitive area of the body (hands, face, feet, etc.)
   • Burn is third degree (see below)
   • Chemicals causing Burn

1^st degree burns

First-degree burns damage only the outer layer of skin.

Characteristics

1. Redness
2. Mild pain
3. Swelling

Treatment

1. Immediately submerge the affected part in cold water.
2. Hold it under cold running water, or place cold, wet cloths on it until the pain decreases.
3. Cover with clean, dry gauze dressing for protection.

2^nd degree burns:

Second-degree burns go through to the second layer of skin.

Characteristics

1. Blisters
2. Rough, red skin
3. Swelling
4. Extreme pain

Treatment

1. Immerse in cold water or have cold, wet cloths applied to it immediately.
2. Gently blot area dry. Do not rub. Rubbing may break the blister, opening it to infection.
3. 3. Cover wound with dry, sterile bandage.
4. 4. If burn is located on arm or leg, keep limb elevated as much as possible.
5. Second-degree burns should heal within a few weeks.

3^rd degree burns:

Even tough, 3^rd degree burns are less painful than second degree burns because the nerve cells in the affected tissue are actually destroyed, the damage is greater. The burn goes through to the third layer of skin.

Characteristics

• Whitish or charred appearance

Treatment

1. Do not remove any clothing near or at the site of the burn
2. Do not apply cold water or medication to the burn.
3. Place clean, dry cloths (i.e. strips of a clean sheet) over the damaged area.
4. If burns are on arms or legs, keep the limbs elevated above the level of the heart.
5. If victim has burns on face, check frequently to make sure he is not having difficulty breathing.
6. Get victim to a hospital at once.

1. Remove clothing on or near the burn area. Never pull clothing over the head with a chemical burn. You may need to cut the clothing.
2. Wash the area thoroughly with low-pressure water for at least 20 minutes.
3. Apply a clean dressing to the area.
4. Get medical attention as soon as possible.

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